Objective:In this study, we evaluated the frequency of euthyroid sick syndrome (ESS) among patients with childhood cancer and its association with the stage of disease, nutritional parameters and cytokines levels.Methods:Eighty newly diagnosed children were included in the study. ESS was assessed in two different ways. According to criteria 1 ESS was present if free triiodothyronine (fT3) was below the lower limit and free thyroxine was within the normal or low limits, thyroid-stimulating hormone (TSH) was in the normal range. According to criteria 2, in addition to the above, it was required that reverse triiodothyronine (rT3) be performed and was higher than normal limits.Results:Three of our pediatric patients had subclinical hypothyroidism and two had subclinical hyperthyroidism. Out of 75 patients, ESS was identified in 14 (17.3%) according to criteria 1 and in eight (10.6%) according to criteria 2. Only fT3 levels were significantly different in the ESS (+) and ESS (-) groups (p<0.05) according to criteria 1. A significantly negative correlation between interleukin (IL)-6 and fT3 was found, according to both sets of criteria. tumor necrosis factor alpha was negatively correlated with fT3 levels only in the criteria 1 group. There were no correlations between IL-1β and fT3, free thyroxine, rT3 and TSH levels.Conclusion:ESS may occur in childhood cancer and thyroid function testing should be performed routinely when cancer is diagnosed.

The treatment of hemangiomas in infancy may be associated with significant morbidity. In addition to morbidity, an objective response cannot be obtained because of the absence of targeted therapeutic options. Herein, we present an infant with a segmental hemangioma and marked glucocorticoid toxicity due to prior steroid therapy that was successfully treated with propranolol. Propranolol was tolerated well and no side effects were observed during the treatment. The only problem to occur was disease recurrence following the withdrawal of propranolol at age 13 months, which was not within the age of spontaneous regression (generally considered as >18 months).

With the improvement of survival rates in childhood cancer, attempts are made to develop less toxic treatment modalities and priority is given to the studies about this subject. Health related quality of life is defined as a multidimensional concept involving physical, emotional, mental and social well being as well as perception of the effects caused by disease and its treatment. In this review, we evaluated health related quality of life and the factors affecting it both in patients receiving cancer treatment and childhood cancer survivors. Furthermore, an emphasize was made to the necessity of parent attendance, parent psychopathology and ways of coping evaluation in the assesment of quality of life in children. Key words: Health, quality of life, childhood cancers ÖZET Çocukluk çağı kanserlerinde genel yaşam hızlarının artmasıyla birlikte, geç yan etkilerin azaltılması hedeflenmekte ve bu konudaki çalışmalara öncelik verilmektedir. Sağlık ilişkili yaşam kalitesi hastanın fiziksel, duygusal, mental ve sosyal davranışlar bakımından iyilik halini kapsayan çok boyutlu bir kavram olup, bir hastalığın ve tedavisinin yarattığı etkilerin hasta tarafından algılanışı olarak tanımlanmaktadır. Bu derlemede kanser tanısı ile tedavi verilen ve/veya tedavisi kesildikten sonra hastalıksız olarak izlenen çocuklarda sağlık ilişkili yaşam kalitesi ve bunu etkileyen faktörlerin gözden geçirilmiştir. Ayrıca, çocukların yaşam kalitesi değerlendirilirken ebeveynlerdeki psikopatolojilerin ve stresle başa çıkma yollarının da mutlaka değerlendirilmesi gerektiğini vurgulamıştır. Anahtar kelimeler: Sağlık, yaşam kalitesi, çocukluk çağı kanserleri

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Conclusion: The prevention and control of infection contributes to the improvement of the prognosis of patients with hematological malignancies. Physicians must be aware of the infection risks and take precautions for infectious complications through the neutropenic period and standard protocols should be established and implemented for patients with hematological malignancies.